Date/Time
Date(s) - 04/18/2026 - 04/26/2026
12:00 am

Location
Hospital Nacional de Niños

Categories

• Medical Missions

A relationship with Hospital Nacional de Niños (HNN), San José, Costa Rica going back to the 1980s, and a recent discussion with Chief of Surgery there, Dr. Jaime Cortés, led Smiles International Foundation President and Founder Dr. Jeff Moses to create another mission program to Central America.

Dr. Cortés related to Dr. Moses that he was indebted to him for providing so much of the care, equipment, and training for their clinic over the years through Smiles International Foundation and the Equipment Matching Grants of Rotary International and SIF sponsorship, including USA training fellowships for two of their craniomaxillofacial surgeons. The clinic was performing very well, and numerous children were receiving care at the elevated level we anticipated, with occasional “tune-up” missions through the years by Dr. Jeff and his teams.

But it turns out that COVID had some additional unexpected effects. The additional pressure on Costa Rica’s Social Security Medical system meant that it failed to provide funds for Pediatric Anesthesia and Operating Room nursing staff. This led to a large exodus of these professionals from HNN, in turn leading to a provision shortage for the Facial-Cleft patients whose numbers had also ballooned in size due to Costa Rica’s “open-border” policy for Nicaraguan and Salvadorian refugees in addition to Costa Rican children with medical issues.

Dr. Cortés mentioned that they currently had 455 children whose operations had been placed on hold, and many of these would pass the age to be eligible for care at HNN (it is a children’s hospital only) before operations could be scheduled. Time was ticking.

Dr. Cortés suggested we run a focus training and clinical surgical provision clinic, with his facility dedicating to our team TWO operating rooms from 5am to 6pm over the course of one week, and preselection of 60 children, taken from his backlog list, with facial cleft deformities ONLY ( as a requirement of Dr. Jeff). Operating for SIX days straight with only five patients requiring (as the last cases of each day) inpatient resources. The other 54 cases would be outpatient discharges per our Mission Care Protocol.

This would be in comparison to their usual weekly output of 2-3 cases per day, with each having INPATIENT RESOURCES REQUIRED. This project would demonstrate to their current anesthesia, recovery and operating room nurses that a large number of patients could be treated in this modern and safe fashion. Not only would they be able to bring the backlog of cases into control, but with us returning at least three years in a row, we would continue to give professional Grand Round Lectures working side-by-side with their teams, training and sharing these successful modern methods with the HNN staff. I am confident that this would lead to long-ranging beneficial changes.

The first mission is April 18-26, 2026. Our team is very much looking forward to opening this new avenue of care.